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Evidence-Based Practice Guide

Since its introduction in the late 1970s, the hierarchy of evidence has evolved from ranking original studies to incorporating pre-appraised/filtered resources. The EBP Pyramid – developed by Dartmouth and Yale (Glover, 2006) – organizes resources into three categories:

  1. Filtered/pre-appraised
  2. Unfiltered/unappraised
  3. Background information/resources

Note the inverse relationship between quantity and quality/relevance of information. At the top of the pyramid are the systematic reviews/meta-analyses, generally considered the highest level of evidence. Since you may not find the answer in a systematic review/meta-analysis, you may need to search other resources. As you go down the pyramid, the amount of information – and, as a corollary, the time necessary to synthesize the information – increases while the quality and/or relevance of the information decreases.

—Sources: Dicenso, Bayley, & Haynes, 2009; Evans, 2003; Grandage, Slawson, & Shaughnessy, 2002.


TRIP (Turning Research Into Practice)


The EBP Pyramid also includes the TRIP Database. This clinical search tool simultaneously searches most of the listed resources and is designed to assist healthcare professionals in rapidly identifying the highest quality clinical evidence for clinical practice.
SumSearch 2 SUMSearch simultaneously searches for original studies, systematic reviews, and practice guidelines from PubMed.